摘要
目的观察亚低温治疗对缺氧缺血性脑病(HIE)新生儿血清白细胞介素17(IL-17)和基质金属蛋白酶9(MMP-9)含量及新生儿行为神经评分(NBNA)的影响。方法选择解放军第153中心医院新生儿重症监护病房2011年10月至2013年12月收治的中、重度HIE患儿,采用酶联免疫吸附法测定亚低温治疗(亚低温组)及常规治疗(常规组)患儿治疗前及治疗72 h后的血清IL-17、MMP-9含量,并与正常对照组进行比较。亚低温组和常规组患儿分别于生后14天及28天进行NBNA评分。结果治疗前,亚低温组(31例)和常规组(30例)血清IL-17和MMP-9含量均高于正常对照组[IL-17:(95.5±13.2)、(96.2±13.1)比(41.6±5.3)pg/ml,MMP-9:(123.9±19.4)、(122.4±18.9)比(58.9±6.2)ng/ml,P<0.01],亚低温组和常规组比较差异无统计学意义(P>0.05)。治疗72 h后,亚低温组和常规组血清IL-17、MMP-9含量均较治疗前降低,但亚低温组较常规组降低更显著[IL-17:(51.1±7.0)比(59.7±8.1)pg/ml,MMP-9:(70.0±7.3)比(82.5±9.1)ng/ml,P<0.01]。生后14、28天亚低温组NBNA评分高于常规组[14天:(34.6±1.5)比(33.9±1.2)分,28天:(36.5±1.3)比(35.4±2.2)分,P<0.05]。结论亚低温治疗可抑制HIE新生儿IL-17、MMP-9产生或释放,可能与亚低温治疗疗效有关,具体机制有待进一步研究。
Objective To investigate the effect of mild hypothermia on interleukin-17（ IL-17）and matrix metalloproteinase-9（ MMP-9） in the serum of neonates with hypoxic ischemic encephalopathy（ HIE）,as well as to evaluate the effect on neonatal behavioral neurological assessment（ NBNA score）.Methods The neonates with moderate or severe HIE selected in the study were hospitalized in the NICU in No. 153 Central Hospital of PLA from October in 2011 to December in 2013. The concentrations of the IL-17,MMP-9 in serum were detected by ELISA in neonates with HIE treated with mild hypothermia and conventional methods（ hypothermia group） and in neonates with HIE treated only with conventional methods（ conventional group） before and 72 hours after the treatment. The results were compared with those in normal neonates（ control group）. The NBNA scores were compared between the hypothermia group and conventional group 14 days and 28 days after the birth. Results Before the treatment the concentrations of IL-17（ pg / ml）,MMP-9（ ng / ml） in the hypothermia group（ n = 31） and in the conventional group（ n = 30） were higher than those in the control group（ n = 30） [ IL-17：（ 95. 5 ±13. 2）,（ 96. 2 ± 13. 1） vs.（ 41. 6 ± 5. 3）; MMP-9：（ 123. 9 ± 19. 4）,（ 122. 4 ± 18. 9） vs.（ 58. 9 ±6. 2）,P 〈0. 01]. There was no statistical difference in the concentrations of the IL-17,MMP-9 between the hypothermia group and conventional group（ P 〉0. 05）. 72 hours after treatment,the concentrations of IL-17,MMP-9 had decreased respectively in the hypothermia group and in the conventional group,but the decrease was greater in the hypothermia group than in the conventional group [（ 51. 1 ± 7. 0） vs.（ 59. 7 ± 8. 1）,（ 70. 0 ± 7. 3） vs.（ 82. 5 ± 9. 1）,P 〈0. 01]. At both 14 and 28 days after birth,the NBNA scores were higher in the hypothermia group than those in the conventional group [（ 34. 6 ± 1. 5） vs.（ 33. 9 ±1. 2）,（ 36. 5 ± 1. 3） vs.（ 35. 4 ± 2. 2）,P 〈0. 05]. Conclusions Mild hypothermia treatment can inhibit the production or release of IL-17 and MMP-9 in neonates with HIE. This perhaps contributes to the neuroprotection of mild hypothermia against HIE. More should be done to explore the mechanism.
出处
《中国新生儿科杂志》
CAS
2015年第4期259-263,共5页
Chinese Journal of Neonatology
基金
河南省科技发展计划项目(132102310004)
